Treatments of Acquired Apraxia of Speech

描述(由申请人提供)： 摘要获得性言语失用症(AOS)是一种以语速减慢、发音困难、韵律紊乱为特征的神经性言语障碍。关于其患病率的数据有限，但Duffy(2005)报告称，在6101例神经运动性言语障碍患者中，AOS是7.6%的主要沟通障碍。作为二次诊断(例如，伴随失语症)，AOS发生的频率更高。从AOS治疗研究的数量和质量来看，AOS治疗的证据基础都很薄弱。然而，有足够的数据支持这样一种说法，即即使在AOS是慢性的情况下，AOS的行为治疗也有望导致言语产生的改善(Wambaugh等人，2006年)。这项拟议的研究的目的是检查对患有慢性、中度-重度到轻度-中度AOS的说话者的治疗效果。采用发声治疗(SPT)研究随机练习和阻断练习对运动学习变量的影响。计划中的调查旨在阐明使用这两种做法管理的SPT的习得、维持和推广效果。将采用分组和单一受试者相结合的实验设计。24名患有AOS的参与者将被分配到两个治疗组中的一个(每组12人)。其中一组将接受SPT-BLOCKED，然后是SPT-Random。另一组将以相反的顺序接受治疗(SPT-随机，然后SPT-阻止)。每个参与者都将接受在单一受试者、多个行为基线设计的背景下进行的治疗。主要的因变量将是语音的清晰度。将对每个参与者进行基线阶段，然后应用SPT-BLOCKED或SPT-Random。在第一阶段的治疗之后，将有两周的时间不治疗。在此期间，将延长未训练行为的基线，以确保在第二阶段治疗之前反应的稳定性。在两周的时间结束时，将进行探查，以测量训练行为的短期维持。两周后，第二次治疗将应用于剩余的一组行为。所有行为的跟踪测试将在所有治疗停止后2、6和10周进行。将根据训练行为的获得率(即，目标语音的发音)和效果大小来比较不同组的表现。小组内部和个人内部的表现也将得到评估。此外，不熟悉的听众(认证的语音/语言病理学家)将使用处理前和处理后的语音样本对语音自然度和可理解性进行评级。

DESCRIPTION (provided by applicant): Project Abstract Acquired apraxia of speech (AOS) is a neurologic speech disorder that is characterized by slowed rate of speech, difficulties in sound production, and disrupted prosody. There are limited data concerning its prevalence, but Duffy (2005) reported that AOS was the primary communication disorder in 7.6% of 6101cases of neurologic motor speech disorders. As a secondary diagnosis (e.g., accompanying aphasia) AOS occurs even more frequently. The AOS treatment evidence base is meager in terms of both quantity and quality of AOS treatment investigations. However, sufficient data exist to support the statement that behavioral treatments for AOS may be expected to result in improvements in speech production even when AOS is chronic (Wambaugh et al., 2006). The purpose of the proposed research is to examine the effects of a treatment for AOS with speakers with chronic, moderate-severe to mild-moderate AOS. The impact of the motor learning variables of random practice and blocked practice will be investigated with application of Sound Production Treatment (SPT). The planned investigation is designed to explicate the acquisition, maintenance and generalization effects of SPT administered using the two types of practice. A combination of group and single-subject experimental designs will be utilized. Twenty-four participants with AOS will be assigned to one of two treatment groups (12 per group). One group will receive SPT-Blocked followed by SPT- Random. The other group will receive the treatments in the reverse order (SPT-Random followed by SPT-Blocked). Each participant will receive treatment administered in the context of a single-subject, multiple baseline design across behaviors. The primary dependent variable will be articulation of speech sounds. A baseline phase will be conducted with each participant, followed by application of either SPT-Blocked or SPT-Random. A two week period of no treatment will follow the first phase of treatment. During this period, extended baselining of the untrained behaviors will occur to ensure stability of responding prior to the second phase of treatment. At the end of the two week period, probing will occur to measure short term maintenance of trained behaviors. After the two week period, the second treatment will be applied to the remaining set of behaviors. Follow-up testing of all behaviors will occur at 2, 6, and 10 weeks after the cessation of all treatment. Performance across groups will be compared in terms of rate of acquisition of trained behaviors (i.e., articulation of targeted speech sounds) and effect sizes. Performance within groups and within individuals will also be evaluated. In addition, unfamiliar listeners (certified speech/language pathologists) will perform ratings of speech naturalness and intelligibility using pre- and post-treatment speech samples.